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CDE Detailed Report
This report contains detailed information about the selected CDEs.
Note: If at least one CDE was selected from a copyright- or trademark-protected instrument/scale then all of the CDEs from that instrument/scale are included in this report.
Disease: Stroke
Sub-Domain: General Health History
CRF: Prior Functional Status
Item count: 9 (9 distinct CDEs)
CDE ID
CDE Name
Variable Name
Definition / Description
Question Text
Permissible Value
Description
Data Type
Instructions
References
Population
Classification (e.g., Core)
Version #
Version Date
Aliases for Variable Name
CRF Module / Guideline
© or TM
Sub-Domain
Domain
Previous Title
Size
Input Restrictions
Min Value
Max Value
Measurement Type
LOINC ID
SNOMED
caDSR ID
CDISC ID
C06005
Data collected date and time
DataCollDateTime
Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performed.
Date information collected
  
Date or Date & Time
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).
No references available
Adult;Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
Prior Functional Status
General Health History
Participant History and Family History
Data collected date and time
 
Free-Form Entry
       
C14639
Ambulatory status
AmbulatStatus
Status that reflects the participant's/subject's ability to walk
Ambulatory status
Able to ambulate independently (no help from another person) w/ or w/o device;With assistance (from person);Unable to ambulate;Unknown;
Patient ambulating without assistance (no help from another person) with or without a device. This means Patient is able to ambulate without help from another person. The use of a device, such as a cane, still meets this definition.;Patient ambulating with assistance of another person.;Patient is on bed rest. Patient is only getting out of bed to the bedside commode (or up in chair) and is primarily in the bed (or immobile).;Unknown or not documented. It is unable to determine from documentation.;
Alphanumeric
Choose one that describes the participant's/subject's ability prior to the qualifying stroke event.
Get With The Guidelines (GWTG) Stroke Patient Management Tool Coding Instructions (Updated on 11/4/2009); Paul Coverdell National Acute Stroke Registry
SPS3
Adult;Pediatric
Core
3.0
6/21/2013
Aliases for variable name not defined
Prior Functional Status
General Health History
Participant History and Family History
Ambulatory status
 
Single Pre-Defined Value Selected
       
C18820
Developmental and academic history other text
DevelopmentalAcademicHistOTH
The free-text field related to 'Developmental and academic history type' specifying other text. Specific aspects of the participant's/subject's pre-morbid developmental status and academic function
Other, specify
  
Alphanumeric
For each history type indicate whether or not the participant/subject has a history
International Pediatric Stroke Study (IPSS)
Pediatric
Supplemental
3.0
7/10/2013
Aliases for variable name not defined
Prior Functional Status
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C11084
Developmental and academic history type
DevelopmentalAcademicHistTyp
Specific aspects of the participant's/subject's pre-morbid developmental status and academic function
Does/did the participant/ subject have any of the following
Attention Deficit Hyperactivity Disorder (ADHD);Attention Deficit Disorder (ADD);Delayed acquisition of language/cognitive milestones, diagnosed by a pediatrician or neurologist;Delayed acquisition of motor milestones, diagnosed by a pediatrician or neurologist;Social delay;Hand preference before twelve months of age;Abnormality of gait noted by parent or physician at the time the child began walking;Received or receives special education;Other, specify;
Attention Deficit Hyperactivity Disorder (ADHD);Attention Deficit Disorder (ADD);Delayed acquisition of language/cognitive milestones, diagnosed by a pediatrician or neurologist;Delayed acquisition of motor milestones, diagnosed by a pediatrician or neurologist;Social delay;Hand preference before twelve months of age;Abnormality of gait noted by parent or physician at the time the child began walking;Received or receives special education;Other, specify;
Alphanumeric
For each history type indicate whether or not the participant/subject has a history
International Pediatric Stroke Study (IPSS)
Pediatric
Supplemental
3.0
7/10/2013
Aliases for variable name not defined
Prior Functional Status
General Health History
Participant History and Family History
Developmental and academic history type
 
Single Pre-Defined Value Selected
       
C11085
Developmental and academic history indicator
DevelopmentalAcacdemicHistInd
Whether the participant/subject has a history of the specific aspect of the pre-morbid developmental status or academic function
Does/did the participant/ subject have any of the following
Yes;No;Unknown;
History reported and/or confirmed in medical record;History NOT reported and NOT confirmed in medical record;History reported as unknown or could not be collected;
Alphanumeric
For each history type indicate whether or not the participant/subject has a history. Choose one for each history type.
International Pediatric Stroke Study (IPSS)
Pediatric
Supplemental
3.0
7/10/2013
Aliases for variable name not defined
Prior Functional Status
General Health History
Participant History and Family History
Developmental and academic history indicator
 
Single Pre-Defined Value Selected
       
C11086
School placement type
SchoolPlacementTyp
The description of the type of education the participant/subject receives with details of being with or without assistance.
School placement
Full-time regular education without aide;Full-time regular education with one to one aide;Regular education with pull-out for certain areas;Special education w/minimal inclusion (e.g., lunch);Full time special education with no inclusion;Special (MR/DD) school;Home-schooled;Not in school;Other, specify;
Full-time regular education without aide;Full-time regular education with one to one aide;Regular education with pull-out for certain areas;Special education w/minimal inclusion (e.g., lunch);Full time special education with no inclusion;Special (MR/DD) school;Home-schooled;Not in school;Other, specify;
Alphanumeric
This element can be collected to describe the participant/ subject prior to the stroke event and also to assess the participant/ subject at subsequent time points after the stroke event.
No references available
Pediatric
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Prior Functional Status
General Health History
Participant History and Family History
School placement type
 
Single Pre-Defined Value Selected
       
C18821
School placement other text
SchoolPlacementOTH
The free-text field related to 'School placement type' specifying other text. The description of the type of education the participant/subject receives with details of being with or without assistance.
Other, specify
  
Alphanumeric
This element can be collected to describe the participant/ subject prior to the stroke event and also to assess the participant/ subject at subsequent time points after the stroke event.
No references available
Pediatric
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Prior Functional Status
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C18768
Therapy or rehabilitation other text
TherpyRehabOTH
The free-text field related to 'Therapy or rehabilitation type' specifying other text. Type of therapy or rehabilitation services received by the participant/subject
Other, specify
  
Alphanumeric
Choose all that apply.
This element can be collected to describe the participant/ subject prior to the stroke event and also to assess the participant/ subject at subsequent time points after the stroke event.
International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM): http://www.cdc.gov/nchs/icd/icd9cm.htm
Adult;Pediatric
Supplemental
1.0
5/27/2014
Aliases for variable name not defined
Prior Functional Status
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C05130
Therapy or rehabilitation type
TherpyRehabTyp
Type of therapy or rehabilitation services received by the participant/subject
Specialized therapies and services
  
Alphanumeric
Choose all that apply.
This element can be collected to describe the participant/ subject prior to the stroke event and also to assess the participant/ subject at subsequent time points after the stroke event.
International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM): http://www.cdc.gov/nchs/icd/icd9cm.htm
Adult;Pediatric
Supplemental
3.0
7/20/2013
Aliases for variable name not defined
Prior Functional Status
General Health History
Participant History and Family History
Therapy or rehabilitation type
 
Multiple Pre-Defined Values Selected
       
07-21-2019
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